The Vestibular and Oculomotor Laboratory at the Balance Center offers a full range of diagnostic tests to evaluate vertigo, dizziness, ataxia, and hearing disorders.
Computerized Dynamic Posturography
Computerized dynamic posturography objectively quantifies a patient's sway under a series of different test conditions. Vision is removed (eyes closed) or distorted (sway-referenced), and joint position sensation is distorted by sway-referencing the platform surface on which the patient stands. Sway-referencing means that as the patient sways in one direction so do the visual surroundings, the platform, or both. Sway-referencing removes the effectiveness of vision and proprioception, leaving vestibular function as the remaining modality for balance.
Computerized Electronystagmography/Infrared Video Oculography
Patients' eye movements are recorded (by electrodes or infrared video measurement) to quantify a series of oculomotor functions that have well-defined anatomical pathways in the brainstem and cerebellum. Movements such as saccadic eye movements, smooth pursuit, optokinetic nystagmus, and positional and spontaneous nystagmus are recorded. Caloric irrigation quantifies inner ear vestibular function and is particularly helpful in identifying an asymmetry between the two inner ears. Electronystagmography and audiography are standard tests for patients with vertigo.
Electrocochleography
Electrocochleography evaluates evoked potentials and is used in the neurodiagnostic evaluation of Ménière's disease, which is a disease of the labyrinth that causes hearing loss, tinnitus, and vertigo.
Electroneurography
Electroneurography measures facial-muscle activity evoked by stimulation of the facial nerve. Electroneurography is used to evaluate the status of the facial nerve in patients at risk for various types of dysfunction, including congenital abnormalities, traumatic injury (temporal-bone fracture), tumors in the area of the nerve, and Bell's palsy.
Electro-Oculography
Electro-oculography uses the corneoretinal potential to assess eye position or to assess the function of the retinal pigment layer. Electrodes placed around the eyes detect movement of the globe, allowing changes in eye position to be detected.
Epley Maneuver
Also known as the canalith repositioning maneuver, the Epley maneuver is used to treat benign positional vertigo. The maneuver consists of a series of head and body movements designed to clear the dense material from the affected semicircular canal.
Rotary Chair Vestibular Test
This test is a computerized evaluation of brainstem and vestibular function. The patient sits in complete darkness in a rotating chair that stimulates the inner ear (horizontal semicircular canals). The vestibulo-ocular reflex is measured by the computer over a spectrum of frequencies that simulates natural movement of the head. Brainstem and cerebellar oculomotor activity is determined based on the interaction of visual and vestibular systems. The rotary chair is the most sensitive test for detecting bilateral loss of vestibular function or cerebellar oculomotor abnormalities.
Tilt-Table Testing
This test is used to evaluate recurrent syncope or presyncope of unknown cause.
